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Signs and Symptoms of Anorexia Nervosa

A person may have anorexia nervosa when she diets to the point of weighing only 85 percent of her normal, healthy weight (or a BMI of 17.5), fears gaining weight, is preoccupied with food, develops abnormal eating habits, stops menstruating, or, if male, experiences a decrease in sexual drive or interest in sex.

Anorexia nervosa affects about 1 out of 100 people between the ages of 10 and 20 years old. Anorexia tends to develop in early to midadolescence when body fat increases from 12 percent before puberty to about 20 to 25 percent after.

This increase in body fat is not true weight gain in the adult sense, but a natural biological function of female development. Ninety to 95 percent of anorexics are female and 75 percent of the young women who develop anorexia nervosa do not have a history of being overweight.

In addition to the physical changes that accompany anorexia nervosa, pronounced emotional changes, such as irritability, depression, moodiness, and increasing isolation are also common. In fact, eating disorder experts have developed a profile of personality and family traits characteristic of a person with anorexia nervosa.

Anorexics tend to be compliant, approval seeking, conflict avoiding, perfectionist, socially anxious, and obsessive/compulsive, with average or above-average intelligence. Their family environment may include a mother who is overprotective, critical, intrusive, and domineering, and a father who is passive, withdrawn, and emotionally absent from the family.

Although not every person who develops anorexia exhibits all or even some of these traits — nor may her family — they help paint a picture of the issues that many anorexia nervosa sufferers must struggle to overcome.

Do you (or someone you know) have any of the following symptoms? The more “yes” answers, the greater the likelihood that you (or she) may have anorexia nervosa.

  • Skips meals, takes only tiny portions, and will not eat in front of other people.

  • Eats in ritualistic ways, such as cutting up food into extremely small bites or chewing every bite excessively, and creates strange food combinations.

  • Grocery shops and cooks for the entire household but will not eat.

  • Always makes excuses not to eat: “not hungry,” “just ate with a friend,” “feeling ill,” and avoids mealtime or situations involving food.

  • Becomes “disgusted” with former favorite foods, such as red meat and desserts.

  • Will eat only a few “safe” foods; boasts about how healthy the meals she does consume are; drastically reduces or completely eliminates an entire group of foods, such as carbohydrates or fats.

  • Says that she’s too fat, even when this is not true, and has a distorted body image.

  • Becomes argumentative with people who try to help.

  • Has trouble concentrating.

  • Denies anger, making statements such as, “Everything is okay; I’m just tired and stressed.”

  • Withdraws into self, becoming socially isolated.

  • Often exercises excessively and follows a rigid routine.

  • Wears baggy clothing to hide thinness.

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